Phase 1 Safety and Tolerability Study of BMP-7 in Symptomatic Knee Osteoarthritis

BACKGROUND: There are no proven therapies that modify the structural changes associated with osteoarthritis (OA). Preclinical data suggests that intra-articular recombinant human BMP-7 (bone morphogenetic protein-7) has reparative effects on cartilage, as well as on symptoms of joint pain. The objective of this study was to determine the safety and tolerability as well as dose-limiting toxicity and maximal tolerated dose of intra-articular BMP-7. The secondary objectives were to determine the effect on symptomatic responses through 24 weeks. METHODS: This was a Phase 1, double-blind, randomized, multi-center, placebo-controlled, single-dose escalation safety study consisting of 4 dosing cohorts in participants with knee OA. Each cohort was to consist of 8 treated participants, with treatment allocation in a 3:1 active (intra-articular BMP-7) to placebo ratio. Eligible participants were persons with symptomatic radiographic knee OA over the age of 40. The primary objective of this study was to determine the safety and tolerability of BMP-7 including laboratory assessments, immunogenicity data and radiographic assessments. Secondary objectives were to determine the proportion of participants with a 20%, 50%, and 70% improvement in the WOMAC pain and function subscales at 4, 8, 12, and 24 weeks. Other secondary outcomes included the change from baseline to 4, 8, 12, and 24 weeks for the OARSI responder criteria. RESULTS: The mean age of participants was 60 years and 73% were female. All 33 participants who were enrolled completed the study and most adverse events were mild or moderate and were similar in placebo and BMP-7 groups. The 1 mg BMP-7 group showed a higher frequency of injection site pain and there was no ectopic bone formation seen on plain x-rays. By week 12, most participants in both the BMP-7 and placebo groups experienced a 20% improvement in pain and overall the BMP-7 group was similar to placebo with regard to this measurement. In the participants who received 0.1 mg and 0.3 mg BMP-7, there was a trend toward greater symptomatic improvement than placebo. The other secondary endpoints showed similar trends including the OARSI responder criteria for which the BMP-7 groups had more responders than placebo. CONCLUSIONS: There was no dose limiting toxicity identified in this study. The suggestion of a symptom response, together with the lack of dose limiting toxicity provide further support for the continued development of this product for the treatment of osteoarthritis.ARC Future Fellowship; Stryker Biotec

Upper bounds for inverse domination in graphs

In any graph $G$, the domination number $\gamma(G)$ is at most the independence number $\alpha(G)$. The \emph{Inverse Domination Conjecture} says that, in any isolate-free $G$, there exists pair of vertex-disjoint dominating sets $D, D\u27$ with $|D|=\gamma(G)$ and $|D\u27| \leq \alpha(G)$. Here we prove that this statement is true if the upper bound $\alpha(G)$ is replaced by $\frac{3}{2}\alpha(G) - 1$ (and $G$ is not a clique). We also prove that the conjecture holds whenever $\gamma(G)\leq 5$ or $|V(G)|\leq 16$

Visualization of the maternal immune system at the maternal-fetal interface

In this thesis the aim was to study immune cell interactions at the maternal-fetal interface to understand the role for immune cells during healthy pregnancy development an pregnancy complications. Specifically in cases of recurrent pregnancy loss and chronic histiocytic intervillositis.Financial support for the printing of this theses was provided by GenDx and Standard BiotoolsLUMC / Geneeskund

HERMIONE: a randomized Phase 2 trial of MM-302 plus trastuzumab versus chemotherapy of physician's choice plus trastuzumab in patients with previously treated, anthracycline-naïve, HER2-positive, locally advanced/metastatic breast cancer.

BackgroundHuman epidermal growth factor receptor 2 (HER2)-positive breast cancer is a particularly aggressive form of the disease, and ultimately progresses in patients with metastases on standard therapies. Anthracyclines, such as doxorubicin, are an effective treatment for HER2-positive breast cancer, particularly when administered in combination with trastuzumab - however, doxorubicin-related cardiotoxicity has limited its use. Many patients are therefore never treated with anthracyclines, even upon disease progression, despite the potential for benefit. MM-302 is a novel, HER2-targeted antibody-liposomal doxorubicin conjugate that specifically targets HER2-overexpressing cells. Preclinical and Phase 1 data suggest that MM-302, as a monotherapy or in combination with trastuzumab, could be effective for managing previously treated, anthracycline-naïve, HER2-positive breast cancer, without the cardiotoxicity observed with free doxorubicin formulations.Methods/designHERMIONE is an open-label, multicenter, randomized (1:1) Phase 2 trial of MM-302 plus trastuzumab versus chemotherapy of physician's choice (gemcitabine, capecitabine, or vinorelbine) plus trastuzumab planned to enroll 250 anthracycline-naïve patients with locally advanced/metastatic HER2-positive breast cancer. Key inclusion criteria are: previous treatment with trastuzumab (with or without pertuzumab) in any setting; refractory or intolerant to pertuzumab (refractory to pertuzumab defined as progression in the locally advanced or metastatic setting, or disease recurrence during or within 12 months of completing pertuzumab-containing neoadjuvant and/or adjuvant therapy); and disease progression on, or intolerant to, ado-trastuzumab emtansine for locally advanced or metastatic disease. The trial is currently being conducted at sites in the USA, Canada, and Western Europe. Treatment will be administered in 21-day cycles, and will be continued until disease progression or unacceptable toxicity. The primary endpoint is independently assessed progression-free survival (PFS). Tumor response will be assessed every 6 weeks, and defined according to RECIST v1.1. Secondary endpoints include investigator-assessed PFS, overall survival (OS), OS rates at 6 months and 1 year, objective response rates, safety and tolerability, quality of life, and the pharmacokinetic profile of MM-302 plus trastuzumab.DiscussionThe HERMIONE study will evaluate the efficacy and safety of MM-302 plus trastuzumab in patients with refractory HER2-positive advanced/metastatic breast cancer for whom there are no standard of care therapies with a proven survival advantage.Trial registrationClinicaltrials.gov identifier: NCT02213744 . Registration date: 06AUG2014

A Probabilistic Assessment of Soil Erosion Susceptibility in a Head Catchment of the Jemma Basin, Ethiopian Highlands

Soil erosion represents one of the most important global issues with serious effects on agriculture and water quality, especially in developing countries, such as Ethiopia, where rapid population growth and climatic changes affect widely mountainous areas. The Meskay catchment is a head catchment of the Jemma Basin draining into the Blue Nile (Central Ethiopia) and is characterized by high relief energy. Thus, it is exposed to high degradation dynamics, especially in the lower parts of the catchment. In this study, we aim at the geomorphological assessment of soil erosion susceptibilities. First, a geomorphological map was generated based on remote sensing observations. In particular, we mapped three categories of landforms related to (i) sheet erosion, (ii) gully erosion, and (iii) badlands using a high-resolution digital elevation model (DEM). The map was validated by a detailed field survey. Subsequently, we used the three categories as dependent variables in a probabilistic modelling approach to derive the spatial distribution of the specific process susceptibilities. In this study we applied the maximum entropy model (MaxEnt). The independent variables were derived from a set of spatial attributes describing the lithology, terrain, and land cover based on remote sensing data and DEMs. As a result, we produced three separate susceptibility maps for sheet and gully erosion as well as badlands. The resulting susceptibility maps showed good to excellent prediction performance. Moreover, to explore the mutual overlap of the three susceptibility maps, we generated a combined map as a color composite where each color represents one component of water erosion. The latter map yields useful information for land-use managers and planning purposes

The Evidence for a Pentaquark Signal and Kinematic Reflections

Several recent experiments have reported evidence for a narrow baryon resonance with positive strangeness ($\Theta^+$) at a mass of 1.54 GeV/$c^2$. Baryons with $S=+1$ cannot be conventional $qqq$ states and the reports have thus generated much theoretical speculation about the nature of possible $S=+1$ baryons, including a 5-quark, or pentaquark, interpretation. We show that narrow enhancements in the $K^+n$ effective mass spectrum can be generated as kinematic reflections resulting from the decay of mesons, such as the $f_2(1275)$, the $a_2(1320)$ and the $\rho_3(1690)$.Comment: 4 pages, 4 figure

Safety and pharmacokinetics of MM-302, a HER2-targeted antibody–liposomal doxorubicin conjugate, in patients with advanced HER2-positive breast cancer: A phase 1 dose-escalation study

BackgroundThis phase 1 dose-escalation trial studied MM-302, a novel HER2-targeted PEGylated antibody-liposomal doxorubicin conjugate, in HER2-positive locally advanced/metastatic breast cancer.MethodsPatients were enrolled in four cohorts: MM-302 monotherapy (8, 16, 30, 40, and 50 mg/m2 every 4 weeks [q4w]); MM-302 (30 or 40 mg/m2 q4w) plus trastuzumab (4 mg/kg q2w); MM-302 (30 mg/m2) plus trastuzumab (6 mg/kg) q3w; MM-302 (30 mg/m2) plus trastuzumab (6 mg/kg) and cyclophosphamide (450 mg/m2) q3w.ResultsSixty-nine patients were treated. The most common adverse events (AEs) were fatigue and nausea. Grade 3/4 AEs of special interest included neutropenia, fatigue, mucosal inflammation, anemia, thrombocytopenia, febrile neutropenia, and palmar-plantar erythrodysesthesia. The MTD was not reached. With MM-302 ≥ 30 mg/m2, overall response rate (ORR) was 13% and median progression-free survival (mPFS) 7.4 months (95% CI: 3·5-10·9) in all arms. In 25 anthracycline-naïve patients, ORR was 28·0% and mPFS 10·9 months (95% CI: 1·8-15·3). Imaging with 64Cu-labeled MM-302 visualized tumor-drug penetrance in tumors throughout the body, including the brain.ConclusionMM-302 monotherapy, in combination with trastuzumab, or trastuzumab plus cyclophosphamide, was well tolerated and showed promising efficacy. The selected phase 2 MM-302 dose was 30 mg/m2 plus 6 mg/kg trastuzumab q3w

Development of a Sandwich ELISA to Measure Exposure to Occupational Cow Hair Allergens

Background: Cow hair and dander are important inducers of occupational allergies in cattle-exposed farmers. To estimate allergen exposure in farming environments, a sensitive enzyme immunoassay was developed to measure cow hair allergens. Methods: A sandwich ELISA was developed using polyclonal rabbit antibodies against a mixture of hair extracts from different cattle breeds. To assess the specificity of the assay, extracts from other mammalian epithelia, mites, molds and grains were tested. To validate the new assay, cow hair allergens were measured in passive airborne dust samples from the stables and homes of farmers. Dust was collected with electrostatic dust fall collectors (EDCs). Results: The sandwich ELISA was found to be very sensitive (detection limit: 0.1 ng/ml) and highly reproducible, demonstrating intra-and interassay coefficients of variation of 4 and 10%, respectively. The assay showed no reactivity with mites, molds and grains, but some cross-reactivity with other mammalian epithelia, with the strongest reaction with goat. Using EDCs for dust sampling, high concentrations of bovine allergens were measured in cow stables (4,760-559,400 mu g/m(2)). In addition, bovine allergens were detected in all areas of cattle farmer dwellings. A large variation was found between individual samples (0.3-900 mu g/m(2)) and significantly higher values were discovered in changing rooms. Conclusion: The ELISA developed for the detection of cow hair proteins is a useful tool for allergen quantification in occupational and home environments. Based on its low detection limit, this test is sensitive enough to detect allergens in passive airborne dust. Copyright (C) 2011 S. Karger AG, Base

Physics at a Neutrino Factory

In response to the growing interest in building a Neutrino Factory to produce high intensity beams of electron- and muon-neutrinos and antineutrinos, in October 1999 the Fermilab Directorate initiated two six-month studies. The first study, organized by N. Holtkamp and D. Finley, was to investigate the technical feasibility of an intense neutrino source based on a muon storage ring. This design study has produced a report in which the basic conclusion is that a Neutrino Factory is technically feasible, although it requires an aggressive R&D program. The second study, which is the subject of this report, was to explore the physics potential of a Neutrino Factory as a function of the muon beam energy and intensity, and for oscillation physics, the potential as a function of baseline.Comment: 133 pages, 64 figures. Report to the Fermilab Directorate. Available from http://www.fnal.gov/projects/muon_collider/ This version fixes some printing problem